FIELD OF THIS INVENTION
[0001] The present invention relates to novel PEGylated insulin analogues exhibiting resistance
towards protease, a method for the preparation of such insulin analogues, insulin
preparations containing the insulin analogues of the invention and a method of treating
diabetes mellitus using these insulin analogues.
BACKGROUND OF THIS INVENTION
[0002] Diabetes mellitus is a metabolic disorder in which the ability to utilize glucose
is partly or completely lost. About 5% of all people suffer from diabetes and the
disorder approaches epidemic proportions. Since the introduction of insulin in the
1920's, continuous efforts have been made to improve the treatment of diabetes mellitus.
Since people suffering from diabetes are subject to chronic treatment over several
decades, there is a major need for safe, convenient and life quality improving insulin
formulations.
[0003] Human insulin consists of two polypeptide chains, the so-called A and B chains which
contain 21 and 30 amino acid residues, respectively, and which are interconnected
by two cystine disulphide bridges.
[0004] The oral route is by far the most widely used route for drug administration and is
in general very well accepted by patients, especially for chronic therapies. Administration
of therapeutic peptides or proteins is however often limited to parenteral routes
rather than the preferred oral administration due to several barriers such as enzymatic
degradation in the gastrointestinal (GI) tract and intestinal mucosa, drug efflux
pumps, insufficient and variable absorption from the intestinal mucosa, as well as
first pass metabolism in the liver.
[0005] Normally, insulin formulations are administered by subcutaneous injection. However,
administration by other routes, e.g., orally or pulmonary, would be advantageous due
to patient compliance, safety and convenience. Some of the commercial available insulin
formulations are characterized by a fast onset of action and other formulations have
a relatively slow onset but show a more or less prolonged action.
[0006] Recent formulation designs for oral protein/peptide delivery include co-formulations
with protease inhibitors, permeation enhancers, polymer-based delivery systems and
insulin conjugates. The latter includes hexyl-insulin-monoconjugate-2 (HIM2), a human
insulin analog with a PEG 7-hexyl group attached to B29. In for example
US 7,030,082;
US 6,867,183 and
US 6,770,625, oral HIM2 has been reported to have increased proteolytic stability and bioavailability
compared to insulin.
[0007] The application with our internal reference
7484.000-EP describes protease resistant insulin analogues, none of which are PEGylated.
ASPECTS OF THIS INVENTION
[0008] An aspect of this invention relates to the furnishing of insulin analogues which,
when administered orally, can give a satisfactory control of the blood glucose level.
[0009] Another aspect of this invention relates to the furnishing of insulin analogues which,
when administered pulmonarily, can give a satisfactory control of the blood glucose
level.
[0010] Another aspect of this invention relates to the furnishing of insulin analogues which,
when administered pulmonarily, can give a satisfactory control of the blood glucose
level with a relatively slow onset and a more or less prolonged action.
[0011] The object of this invention is to overcome or ameliorate at least one of the disadvantages
of the prior art, or to provide a useful alternative.
DEFINITIONS
[0012] Herein, the term
insulin covers natural occurring insulins, e.g., human insulin, as well as insulin analogues
thereof.
[0013] Herein the term
amino acid residue covers an amino acid from which a hydrogen atom has been removed from an amino group
and/or a hydroxy group has been removed from a carboxy group and/or a hydrogen atom
has been removed from a mercapto group. Imprecise, an amino acid residue may be designated
an amino acid.
[0014] Herein, the term
insulin analogue covers a polypeptide which has a molecular structure which formally can be derived
from the structure of a naturally occurring insulin, e.g., human insulin, by deleting
and/or substituting (replacing) one or more amino acid residue occurring in the natural
insulin and/or by adding one or more amino acid residue. The added and/or substituted
amino acid residues can either be codable amino acid residues or other naturally occurring
amino acid residues or purely synthetic amino acid residues.
[0015] Herein the term
parent insulin means the insulin without appended PEG moiety.
[0016] Herein, the term
mutation covers any change in amino acid sequence (substitutions and insertions with codable
amino acids as well as deletions).
[0017] Herein, the term
analogues of the A chain and
analogues of the B chains of human insulin covers A and B chains of human insulin, respectively, having one
or more substitutions, deletions and or extensions (additions) of the A and B amino
acid chains, respectively, relative to the A and B chains, respectively, of human
insulin.
[0018] Herein terms like
A1, A2, A3 etc. indicate the position 1, 2 and 3, respectively, in the A chain of insulin (counted
from the N-terminal end). Similarly, terms like
B1, B2, B3 etc. indicates the position 1, 2 and 3, respectively, in the B chain of insulin (counted
from the N-terminal end). Using the one letter codes for amino acids, terms like A21A,
A21G and A21Q designates that the amino acid in the A21 position is A, G and Q, respectively.
Using the three letter codes for amino acids, the corresponding expressions are AlaA21,
GlyA21 and GlnA21, respectively.
[0019] Herein terms like
A-1, B-1, etc., indicate the positions of the first amino acids N-terminally to the A1 and
B1 positions, respectively, and so forth.
[0020] Herein terms like
desB29 and
desB30 indicate an insulin analogue lacking the B29 or B30 amino acid residue, respectively.
[0021] With
fast acting insulin is meant an insulin having a faster onset of action than normal or regular human
insulin.
[0022] With
long acting insulin is meant an insulin having a longer duration of action than normal or regular human
insulin.
[0023] The numbering of the positions in insulin analogues, insulins and A and B chains
is done so that the parent compound is human insulin with the numbering used for it.
[0024] The term
basal insulin as used herein means an insulin peptide which has a time-action of more than 8 hours,
in particularly of at least 9 hours. Preferably, the basal insulin has a time-action
of at least 10 hours. The basal insulin may thus have a time-action in the range from
about 8 to 24 hours, preferably in the range from about 9 to about 15 hours.
[0025] Herein the term
linker covers a chemical moiety which connects an -HN- group of the insulin with the -O-
group of the PEG moiety. The linker does not have any influence on the desired action
of the final PEGylated insulin, especially it does not have any adverse influence.
[0026] With
"PEG" or polyethylene glycol, as used herein is meant any water soluble poly(ethylene oxide).
The expression PEG will comprise the structure -(CH
2CH
2O)
n- where n is an integer from 2 to about 1000. A commonly used PEG is end-capped PEG,
wherein one end of the PEG termini is end-capped with a relatively inactive group
such as alkoxy, while the other end is a hydroxyl group that may be further modified
by linker moieties. An often used capping group is methoxy and the corresponding end-capped
PEG is often denoted mPEG. Hence, mPEG is CH
3O(CH
2CH
2O)
n-, where n is an integer from 2 to about 1000 sufficient to give the average molecular
weight indicated for the whole PEG moiety, e.g., for mPEG Mw 2,000, n is approximately
44 (a number that is subject for batch-to-batch variation). The notion PEG is often
used instead of mPEG.
[0027] Specific PEG forms of this invention are branched, linear, forked, dumbbell PEGs,
and the like and the PEG groups are typically polydisperse, possessing a low polydispersity
index of less than about 1.05. The PEG moieties present in an insulin will for a given
molecular weight typically consist of a range of ethyleneglycol (or ethyleneoxide)
monomers. For example, a PEG moiety of molecular weight 2000 will typically consist
of 44 ± 10 monomers, the average being around 44 monomers. The molecular weight (and
number of monomers) will typically be subject to some batch-to-batch variation.
[0028] Other specific PEG forms are monodisperse that can be branched, linear, forked, or
dumbbell shaped as well. Being monodisperse means that the length (or molecular weight)
of the PEG polymer is specifically defined and is not a mixture of various lengths
(or molecular weights). Herein the notion
mdPEG is used to indicate that the mPEG moiety is monodisperse, using "d" for "discrete".
The number in subscript after mdPEG, for example mdPEG
12, indicates the number of ethyleneglycol monomers within the monodisperse polymer
(oligomer), in this case 12.
[0029] The term
PEGylated insulin covers modification of insulin by attachment of one or more PEG moieties via a linker
to the parent insulin. The PEG moiety can either be attached by nucleophilic substitution
(acylation) on N-terminal alpha-amino groups or on lysine residue(s) on the gamma-positions,
e.g., with OSu-activated esters, or PEG moieties can be attached by reductive alkylation
- also on amino groups present in the insulin molecule - using PEG-aldehyde reagents
and a reducing agent, such as sodium cyanoborohydride, or, alternatively, PEG moieties
can be attached to the sidechain of an unpaired cysteine residue in a Michael addition
reaction using eg. PEG maleimide reagents.
[0030] By PEGylated insulin having
insulin activity is meant a PEGylated insulin with either the ability to lower the blood glucose in
mammalians as measured in a suitable animal model, which may, e.g., be a rat, rabbit,
or pig model, after suitable administration, e.g., by intravenous or subcutaneous
administration, or an insulin receptor binding affinity.
[0031] Herein the term
alkyl covers a saturated, branched or straight hydrocarbon group.
[0032] Herein the term
alkoxy covers the radical "alkyl-O-". Representative examples are methoxy, ethoxy, propoxy
(e.g., 1-propoxy and 2-propoxy), butoxy (e.g., 1-butoxy, 2-butoxy and 2-methyl-2-propoxy),
pentoxy (1-pentoxy and 2-pentoxy), hexoxy (1-hexoxy and 3-hexoxy), and the like.
[0033] Herein the term
alkylene covers a saturated, branched or straight bivalent hydrocarbon group having from 1
to 12 carbon atoms. Representative examples include, but are not limited to, methylene,
1,2-ethylene, 1,3-propylene, 1,2-propylene, 1,3-butylene, 1,4-butylene, 1,4-pentylene,
1,5-pentylene, 1,5-hexylene, 1,6-hexylene, and the like.
[0034] By
high physical stability is meant a tendency to fibrillation being less than 50% of that of human insulin.
Fibrillation may be described by the lag time before fibril formation is initiated
at a given conditions.
[0035] A polypeptide with
insulin receptor and
IGF-1 receptor affinity is a polypeptide which is capable of interacting with an insulin receptor and a human
IGF-1 receptor in a suitable binding assay. Such receptor assays are well-know within
the field and are further described in the examples. The present PEGylated insulin
will not bind to the IGF-1 receptor or will have a rather low affinity to said receptor.
More precisely, the PEGylated insulins of this invention will have an affinity towards
the IGF-1 receptor of substantially the same magnitude or less as that of human insulin
[0036] The terms
treatment and
treating as used herein means the management and care of a patient for the purpose of combating
a disease, disorder or condition. The term is intended to include the delaying of
the progression of the disease, disorder or condition, the alleviation or relief of
symptoms and complications, and/or the cure or elimination of the disease, disorder
or condition. The patient to be treated is preferably a mammal, in particular a human
being.
[0037] The term
treatment of a disease as used herein means the management and care of a patient having developed the disease,
condition or disorder. The purpose of treatment is to combat the disease, condition
or disorder. Treatment includes the administration of the active compounds to eliminate
or control the disease, condition or disorder as well as to alleviate the symptoms
or complications associated with the disease, condition or disorder.
[0038] The term
prevention of a disease as used herein is defined as the management and care of an individual at risk of
developing the disease prior to the clinical onset of the disease. The purpose of
prevention is to combat the development of the disease, condition or disorder, and
includes the administration of the active compounds to prevent or delay the onset
of the symptoms or complications and to prevent or delay the development of related
diseases, conditions or disorders.
[0039] The term
effective amount as used herein means a dosage which is sufficient in order for the treatment of the
patient to be effective compared with no treatment.
[0040] POT is the
Schizosaccharomyces pombe triose phosphate isomerase gene, and
TPI1 is the
S. cerevisiae triose phosphate isomerase gene.
[0041] By a
leader is meant an amino acid sequence consisting of a pre-peptide (the signal peptide)
and a pro-peptide.
[0043] The term
pro-peptide means a polypeptide sequence whose function is to allow the expressed polypeptide
to be directed from the endoplasmic reticulum to the Golgi apparatus and further to
a secretory vesicle for secretion into the culture medium (i.e. exportation of the
polypeptide across the cell wall or at least through the cellular membrane into the
periplasmic space of the yeast cell). The pro-peptide may be the yeast α-factor pro-peptide,
vide
US 4,546,082 and
4,870,008. Alternatively, the pro-peptide may be a synthetic pro-peptide, which is to say a
pro-peptide not found in nature. Suitable synthetic pro-peptides are those disclosed
in
US 5,395,922;
5,795,746;
5,162,498 and
WO 98/32867. The pro-peptide will preferably contain an endopeptidase processing site at the
C-terminal end, such as a Lys-Arg sequence or any functional analogue thereof.
[0044] In the present context, the three-letter or one-letter indications of the amino acids
have been used in their conventional meaning as indicated in the following. Unless
indicated explicitly, the amino acids mentioned herein are L-amino acids. Further,
the left and right ends of an amino acid sequence of a peptide are, respectively,
the N- and C-termini, unless otherwise specified.
Abbreviations for amino acids
Amino acid |
Three-letter code |
One-letter code |
Glycine |
Gly |
G |
Proline |
Pro |
P |
Alanine |
Ala |
A |
Valine |
Val |
V |
Leucine |
Leu |
L |
Isoleucine |
Ile |
I |
Methionine |
Met |
M |
Cysteine |
Cys |
C |
Phenylalanine |
Phe |
F |
Tyrosine |
Tyr |
Y |
Tryptophan |
Trp |
W |
Histidine |
His |
H |
Lysine |
Lys |
K |
Arginine |
Arg |
R |
Glutamine |
Gln |
Q |
Asparagine |
Asn |
N |
Glutamic Acid |
Glu |
E |
Aspartic Acid |
Asp |
D |
Serine |
Ser |
S |
Threonine |
Thr |
T |
[0045] The following abbreviations have been used in the specification and examples: Da
is Dalton (molecular weight), kDa is kilo-Dalton (= 1000 Da), mPEG-SBA is mPEG-CH
2CH
2CH
2-CO-OSu (N-hydroxysuccinimidyl ester of mPEG-butanoic acid), mPEG-SMB is mPEG-CH
2CH
2CH(CH
3)-CO-OSu (N-hydroxysuccinimidyl ester of mPEG-α-methylbutanoic acid), mPEG-SPA is
mPEG-CH
2CH
2-CO-OSu (N-hydroxysuccinimidyl ester of mPEG-propionic acid), Mw is molecular weight,
OSu is 1-succinimidyloxy = 2,5-dioxopyrrolidin-1-yloxy, R is room temperature, SA
is sinapinic acid and Su is 1-succinimidyl = 2,5-dioxopyrrolidin-1-yl.
SUMMARY OF THE INVENTION
[0046] It has been discovered that insulins that are stabilised towards proteolytic degradation
(by specific mutations) and PEGylated at the B29-Lysine are efficacious and protracted
and possess high potential as protracted insulins that can be administered pulmonary
or orally. Furthermore, after oral administration, these PEGylated insulins have a
higher degree of bioavailability than similar known PEGylated insulins, that are not
stabilised towards proteolytic degradation. Hence, these PEGylated insulin analogues
are valuable for oral administration. Similarly, after pulmonary administration, these
PEGylated protease stabilised insulins displays higher apparent potency and/or bioavailability
than similar known PEGylated insulins, that are not stabilised towards proteolytic
degradation. Furthermore, these PEGylated protease stabilised insulins displays protracted
time-action profiles when administered pulmonary to mammals. Hence, these PEGylated
insulin analogues are valuable for pulmonary administration.
[0047] Via a suitable linker group, a PEG group can be attached to side chain(s) of lysine
or cysteine residue(s) when present or attached to the N-terminal amino group(s) or
at both places in the parent insulin. The linker is typically a derivative of a carboxylic
acid, where the carboxylic acid functionality is used for attachment to the parent
insulin via an amide bond. The linker may be an acetic acid moiety with the linking
motif: -CH
2CO-, a propionic acid moiety with the linking motif: -CH
2CH
2CO- or -CHCH
3CO-, or a butyric acid moiety with the linking motif: -CH
2CH
2CH
2CO- or -CH
2CHCH
3CO-. Alternatively, the linker may be a -CO- group.
[0048] PEGylation of the lysine residue present in position B29 in the human insulin B-chain
is desired. Furthermore, it is desirable that there is no Lys present in any of the
positions 1 through 21 in the A chain (A1-A21) and no Lys present in any of the positions
1 through 28 in the B chain (B1-B28). A preferred parent insulin is an insulin having
no B30 amino acid.
[0049] The parent insulin molecule have a limited number of the naturally occurring amino
acid residues substituted with other amino acid residues relative to human insulin
as explained in the detailed part of the specification.
[0050] In one embodiment, this invention relates to a PEGylated insulin, wherein the parent
insulin analogue deviates from human insulin in one or more of the following deletions
or substitutions: Q in position A18, A, G or Q in position A21, G or Q in position
B1 or no amino acid residue in position B1, Q, S or T in position B3 or no amino acid
residue in position B3, Q in position B13, no amino acid residue in position B27,
D, E or R in position B28 and no amino acid in position B30.
[0051] The PEG group may vary in size within a large range as is well known within the art.
However, too large PEG groups may interfere in a negative way with the biological
activity of the PEGylated insulin molecule.
[0052] In still a further aspect, this invention is related to pharmaceutical preparations
comprising the PEGylated insulin of this invention and suitable adjuvants and additives
such as one or more agents suitable for stabilization, preservation or isotoni, e.g.,
zinc ions, phenol, cresol, a parabene, sodium chloride, glycerol or mannitol. The
zinc content of the present formulations may be between 0 and about 6 zinc atoms per
insulin hexamer. The pH value of the pharmaceutical preparation may be between about
4 and about 8.5, between about 4 and about 5 or between about 6.5 and about 7.5.
[0053] In a further embodiment, this invention is related to the use of the PEGylated insulin
as a pharmaceutical for the reducing of blood glucose levels in mammalians, in particularly
for the treatment of diabetes.
[0054] In a further aspect, this invention is related to the use of the PEGylated insulin
for the preparation of a pharmaceutical preparation for the reducing of blood glucose
level in mammalians, in particularly for the treatment of diabetes.
[0055] In a further embodiment, this invention is related to a method of reducing the blood
glucose level in mammalians by administrating a therapeutically active dose of a PEGylated
insulin of this invention to a patient in need of such treatment.
[0056] In a further aspect of this invention, the PEGylated insulins are administered in
combination with one or more further active substances in any suitable ratios. Such
further active agents may be selected from human insulin, fast acting insulin analogues,
antidiabetic agents, antihyperlipidemic agents, antiobesity agents, antihypertensive
agents and agents for the treatment of complications resulting from or associated
with diabetes.
[0057] In one embodiment, the two active components are administered as a mixed pharmaceutical
preparation. In another embodiment, the two components are administered separately
either simultaneously or sequentially.
[0058] In one embodiment, the PEGylated insulins of this invention may be administered together
with fast acting human insulin or human insulin analogues. Such fast acting insulin
analogue may be such wherein the amino acid residue in position B28 is Asp, Lys, Leu,
Val, or Ala and the amino acid residue in position B29 is Lys or Pro, des(B28-B30),
des(B27) or des(B30) human insulin, and an analogue wherein the amino acid residue
in position B3 is Lys and the amino acid residue in position B29 is Glu or Asp. The
PEGylated insulin of this invention and the rapid acting human insulin or human insulin
analogue can be mixed in a ratio from about 90% of the PEGylated insulin to about
10% of the rapid acting human insulin or human insulin analogue; preferably from about
70% of the PEGylated insulin to about 30% of the rapid acting human insulin or human
insulin analogue, and even more preferred from about 50 % of the PEGylated insulin
to about 50% of the rapid acting human insulin or human insulin analogue (% being
weight percentage).
[0059] The PEGylated insulins of this invention may also be used on combination treatment
together with an antidiabetic agent.
[0060] Antidiabetic agents will include insulin, GLP-1 (1-37) (glucagon like peptide-1)
described in
WO 98/08871,
WO 99/43706,
US 5424286 and
WO 00/09666, GLP-2, exendin-4(1-39), insulinotropic fragments thereof, insulinotropic analogues
thereof and insulinotropic derivatives thereof. Insulinotropic fragments of GLP-1
(1-37) are insulinotropic peptides for which the entire sequence can be found in the
sequence of GLP-1 (1-37) and where at least one terminal amino acid has been deleted.
[0061] The PEGylated insulins of this invention may also be used on combination treatment
together with an oral antidiabetic such as a thiazolidindione, metformin and other
type 2 diabetic pharmaceutical preparation for oral treatment.
[0062] Furthermore, the PEGylated insulin of this invention may be administered in combination
with one or more antiobesity agents or appetite regulating agents.
[0063] In one embodiment this invention is related to a pulmonal pharmaceutical preparation
comprising the PEGgylated insulin of this invention and suitable adjuvants and additives
such as one or more agents suitable for stabilization, preservation or isotoni, e.g.,
zinc ions, phenol, cresol, a parabene, sodium chloride, glycerol, propyleneglycol
or mannitol.
[0064] It should be understood that any suitable combination of the PEGylated insulins with
diet and/or exercise, one or more of the above-mentioned compounds and optionally
one or more other active substances are considered to be within the scope of this
invention.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0065] The stability and solubility properties of insulin are important underlying aspects
for current insulin therapy. This invention is addressed to these issues by providing
stable, PEGylated insulin analogues wherein the PEGylation decreases molecular flexibility
and concomitantly reduce the fibrillation propensity and limit or modify the pH precipitation
zone.
[0066] The PEGylated insulins of this invention are in particularly intended for pulmonary
or oral administration due to their relatively high bioavailability compared to, e.g.,
human insulin and PEGylated human insulin. Furthermore, the PEGylated insulins will
have a protracted insulin activity.
[0067] Because virtually all PEG polymers are mixtures of many large molecules, one must
resort to averages to describe molecular weight. Among many possible ways of reporting
averages, three are commonly used: the
number average, weight average, and
z-average molecular weights. The weight average is probably the most useful of the three, because
it fairly accounts for the contributions of different sized chains to the overall
behaviour of the polymer, and correlates best with most of the physical properties
of interest.
• Number average

• Weight average

• Z average

where N
i is the mole-fraction (or the number-fraction) of molecules with molecular weight
M
i in the polymer mixture. The ratio of M
w to M
n is known as the
polydispersity index (PDI), and provides a rough indication of the breadth of the distribution. The PDI
approaches 1.0 (the lower limit) for special polymers with very narrow MW distributions.
[0068] While lower molecular weight PEG groups may be preferred for increasing bioavailability,
high molecular weight PEG chains, e.g., having an average molecular weight of 4000-6000
daltons or greater, although generally found to decrease the bioactivity of the insulin
molecule, may be preferred for increasing half-life.
[0069] The PEG groups used in this invention will typically comprise a number of (-OCH
2CH
2-) subunits.
[0070] The PEG groups used in this invention will for a given molecular weight typically
consist of a range of ethyleneglycol (or ethyleneoxide) monomers. For example, a PEG
group of molecular weight 2000 dalton will typically consist of 43 ± 10 monomers,
the average being around 43-44 monomers, or 35-50 monomers.
[0071] The PEGylated insulins of this invention are mono-substituted having only one PEG
group attached to a lysine amino acid residue in the parent insulin molecule.
[0072] In this application, the PEGylated insulins are, to a great extent, named as if the
linking moiety is a propionic acid linker, irrespective of the actual linker. In fact,
within protein PEGylation literature, it is rarely specified which linking groups
are used. The important variables are, with respect to biological properties: Size
(in Daltons) and shape of the PEG moiety and position of the PEG attachment within
the protein.
[0073] The parent insulins are produced by expressing a DNA sequence encoding the insulin
in question in a suitable host cell by well known technique as disclosed in, e.g.,
US patent No. 6,500,645. The parent insulin is either expressed directly or as a precursor molecule which
has an N-terminal extension on the B-chain. This N-terminal extension may have the
function of increasing the yield of the directly expressed product and may be of up
to 15 amino acid residues long. The N-terminal extension is to be cleaved of in vitro
after isolation from the culture broth and will therefore have a cleavage site next
to B1. N-terminal extensions of the type suitable in this invention are disclosed
in
U.S. Patent No. 5,395,922, and European Patent No.
765,395A.
[0074] The polynucleotide sequence coding for the parent insulin may be prepared synthetically
by established standard methods, e.g., the phosphoamidite method described by
Beaucage et al. (1981) Tetrahedron Letters 22:1859-1869, or the method described by
Matthes et al. (1984) EMBO Journal 3: 801-805. According to the phosphoamidite method, oligonucleotides are synthesized, e.g.,
in an automatic DNA synthesizer, purified, duplexed and ligated to form the synthetic
DNA construct. A currently preferred way of preparing the DNA construct is by polymerase
chain reaction (PCR).
[0075] The polynucleotide sequences may also be of mixed genomic, cDNA, and synthetic origin.
For example, a genomic or cDNA sequence encoding a leader peptide may be joined to
a genomic or cDNA sequence encoding the A and B chains, after which the DNA sequence
may be modified at a site by inserting synthetic oligonucleotides encoding the desired
amino acid sequence for homologous recombination in accordance with well-known procedures
or preferably generating the desired sequence by PCR using suitable oligonucleotides.
[0076] The recombinant method will typically make use of a vector which is capable of replicating
in the selected microorganism or host cell and which carries a polynucleotide sequence
encoding the parent insulin. The recombinant vector may be an autonomously replicating
vector,
i.e., a vector which exists as an extra-chromosomal entity, the replication of which
is independent of chromosomal replication, e.g., a plasmid, an extra-chromosomal element,
a mini-chromosome, or an artificial chromosome. The vector may contain any means for
assuring self-replication. Alternatively, the vector may be one which, when introduced
into the host cell, is integrated into the genome and replicated together with the
chromosome(s) into which it has been integrated. Furthermore, a single vector or plasmid
or two or more vectors or plasmids which together contain the total DNA to be introduced
into the genome of the host cell, or a transposon may be used. The vector may be linear
or closed circular plasmids and will preferably contain an element(s) that permits
stable integration of the vector into the host cell's genome or autonomous replication
of the vector in the cell independent of the genome.
[0077] The recombinant expression vector is capable of replicating in yeast. Examples of
sequences which enable the vector to replicate in yeast are the yeast plasmid 2 µm
replication genes REP 1-3 and origin of replication.
[0078] The vector may contain one or more selectable markers which permit easy selection
of transformed cells. A selectable marker is a gene the product of which provides
for biocide or viral resistance, resistance to heavy metals, prototrophy to auxotrophs,
and the like. Examples of bacterial selectable markers are the
dal genes from
Bacillus subtilis or
Bacillus licheniformis, or markers which confer antibiotic resistance such as ampicillin, kanamycin, chloramphenicol
or tetracycline resistance. Selectable markers for use in a filamentous fungal host
cell include
amdS (acetamidase),
argB (or- nithine carbamoyltransferase),
pyrG (orotidine-5'-phosphate decarboxylase) and
trpC (anthranilate synthase. Suitable markers for yeast host cells are ADE2, HIS3, LEU2,
LYS2, MET3, TRP1, and URA3. A well suited selectable marker for yeast is the
Schizosaccharomyces pompe TPI gene (
Russell (1985) Gene 40:125-130).
[0079] In the vector, the polynucleotide sequence is operably connected to a suitable promoter
sequence. The promoter may be any nucleic acid sequence which shows transcriptional
activity in the host cell of choice including mutant, truncated, and hybrid promoters,
and may be obtained from genes encoding extra-cellular or intra-cellular polypeptides
either homologous or heterologous to the host cell.
[0080] Examples of suitable promoters for directing the transcription in a bacterial host
cell, are the promoters obtained from the
E.
coli lac operon,
Streptomyces coelicolor agarase gene
(dagA), Bacillus subtilis levansucrase gene
(sacB), Bacillus licheniformis alpha-amylase gene (
amyL)
, Bacillus stearothermophilus maltogenic amylase gene (
amyM)
, Bacillus amyloliquefaciens alpha-amylase gene (
amyQ)
, and
Bacillus licheniformis penicillinase gene
(penP). Examples of suitable promoters for directing the transcription in a filamentous fungal
host cell are promoters obtained from the genes for
Aspergillus oryzae TAKA amylase,
Rhizomucor miehei aspartic proteinase,
Aspergillus niger neutral alpha-amylase, and
Aspergillus niger acid stable alpha-amylase. In a yeast host, useful promoters are the
Saccharomyces cerevisiae Ma1, TPI, ADH or PGK promoters.
[0082] The procedures used to ligate the polynucleotide sequence encoding the parent insulin,
the promoter and the terminator, respectively, and to insert them into a suitable
vector containing the information necessary for replication in the selected host,
are well known to persons skilled in the art. It will be understood that the vector
may be constructed either by first preparing a DNA construct containing the entire
DNA sequence encoding the insulins of this invention, and subsequently inserting this
fragment into a suitable expression vector, or by sequentially inserting DNA fragments
containing genetic information for the individual elements (such as the signal, pro-peptide,
connecting peptide, A and B chains) followed by ligation.
[0083] The vector comprising the polynucleotide sequence encoding the parent insulin is
introduced into a host cell so that the vector is maintained as a chromosomal integrant
or as a self-replicating extra-chromosomal vector. The term "host cell" encompasses
any progeny of a parent cell that is not identical to the parent cell due to mutations
that occur during replication. The host cell may be a unicellular microorganism, e.g.,
a prokaryote, or a non-unicellular microorganism, e.g., a eukaryote. Useful unicellular
cells are bacterial cells such as gram positive bacteria including, but not limited
to, a
Bacillus cell,
Streptomyces cell, or gram negative bacteria such as
E.
coli and
Pseudomonas sp. Eukaryote cells may be mammalian, insect, plant, or fungal cells. In one embodiment,
the host cell is a yeast cell. The yeast organism may be any suitable yeast organism
which, on cultivation, produces large amounts of the single chain insulin of the invention.
Examples of suitable yeast organisms are strains selected from the yeast species
Saccharomyces cerevisiae, Saccharomyces kluyveri, Schizosaccharomyces pombe, Sacchoromyces
uvarum, Kluyveromyces lactis, Hansenula polymorpha, Pichia pastoris, Pichia methanolica,
Pichia kluyveri, Yarrowia lipolytica, Candida sp., Candida utilis, Candida cacaoi,
Geotrichum sp., and
Geotrichum fermentans.
[0084] The transformation of the yeast cells may for instance be effected by protoplast
formation followed by transformation in a manner known
per se. The medium used to cultivate the cells may be any conventional medium suitable for
growing yeast organisms. The secreted insulin, a significant proportion of which will
be present in the medium in correctly processed form, may be recovered from the medium
by conventional procedures including separating the yeast cells from the medium by
centrifugation, filtration or catching the insulin precursor by an ion exchange matrix
or by a reverse phase absorption matrix, precipitating the proteinaceous components
of the supernatant or filtrate by means of a salt, e.g., ammonium sulphate, followed
by purification by a variety of chromatographic procedures, e.g., ion exchange chromatography,
affinity chromatography, or the like.
PHARMACEUTICAL COMPOSITIONS
[0085] The PEGylated insulins of this invention may be administered subcutaneously, nasally,
orally, or pulmonary.
[0086] For subcutaneous administration, the PEGylated insulins of this invention are formulated
analogously with the formulation of known insulins. Furthermore, for subcutaneous
administration, the PEGylated insulins of this invention are administered analogously
with the administration of known insulins and, generally, the physicians are familiar
with this procedure.
[0087] PEGylated insulins of this invention may be administered by inhalation in a dose
effective to increase circulating insulin levels and/or to lower circulating glucose
levels. Such administration can be effective for treating disorders such as diabetes
or hyperglycemia. Achieving effective doses of insulin requires administration of
an inhaled dose of more than about 0.5 µg/kg to about 50 µg/kg of PEGylated insulins
of this invention. A therapeutically effective amount can be determined by a knowledgeable
practitioner, who will take into account factors including insulin level, blood glucose
levels, the physical condition of the patient, the patient's pulmonary status, or
the like.
[0088] The PEGylated insulins of this invention may be delivered by inhalation to achieve
slow absorption and/or reduced systemical clearance thereof. Different inhalation
devices typically provide similar pharmacokinetics when similar particle sizes and
similar levels of lung deposition are compared.
[0089] The PEGylated insulins of this invention may be delivered by any of a variety of
inhalation devices known in the art for administration of a therapeutic agent by inhalation.
These devices include metered dose inhalers, nebulizers, dry powder generators, sprayers,
and the like. Preferably, the PEGylated insulins of this are delivered by a dry powder
inhaler or a sprayer. There are a several desirable features of an inhalation device
for administering PEGylated insulins of this invention. For example, delivery by the
inhalation device is advantageously reliable, reproducible, and accurate. The inhalation
device should deliver small particles or aerosols, e.g., less than about 10 µm, for
example about 1-5 µm, for good respirability. Some specific examples of commercially
available inhalation devices suitable for the practice of this invention are Turbohaler
™ (Astra), Rotahaler
® (Glaxo), Diskus
® (Glaxo), Spiros
™ inhaler (Dura), devices marketed by Inhale Therapeutics, AERx
™ (Aradigm), the Ultravent
® nebulizer (Mallinckrodt), the Acorn II
® nebulizer (Marquest Medical Products), the Ventolin
® metered dose inhaler (Glaxo), the Spinhaler
® powder inhaler (Fisons), or the like.
[0090] As those skilled in the art will recognize, the formulation of PEGylated insulins
of this invention, the quantity of the formulation delivered and the duration of administration
of a single dose depend on the type of inhalation device employed. For some aerosol
delivery systems, such as nebulizers, the frequency of administration and length of
time for which the system is activated will depend mainly on the concentration of
PEGylated insulins in the aerosol. For example, shorter periods of administration
can be used at higher concentrations of PEGylated insulins in the nebulizer solution.
Devices such as metered dose inhalers can produce higher aerosol concentrations, and
can be operated for shorter periods to deliver the desired amount of the PEGylated
insulins. Devices such as powder inhalers deliver active agent until a given charge
of agent is expelled from the device. In this type of inhaler, the amount of insulin
PEGylated insulins of this invention in a given quantity of the powder determines
the dose delivered in a single administration.
[0091] The particle size of PEGylated insulins of this invention in the formulation delivered
by the inhalation device is critical with respect to the ability of insulin to make
it into the lungs, and preferably into the lower airways or alveoli. Preferably, the
PEGylated insulins of this invention ion is formulated so that at least about 10%
of the PEGylated insulins delivered is deposited in the lung, preferably about 10
to about 20%, or more. It is known that the maximum efficiency of pulmonary deposition
for mouth breathing humans is obtained with particle sizes of about 2 µm to about
3 µm. When particle sizes are above about 5 µm, pulmonary deposition decreases substantially.
Particle sizes below about 1 µm cause pulmonary deposition to decrease, and it becomes
difficult to deliver particles with sufficient mass to be therapeutically effective.
Thus, particles of the PEGylated insulins delivered by inhalation have a particle
size preferably less than about 10 µm, more preferably in the range of about 1 µm
to about 5 µm. The formulation of the PEGylated insulins is selected to yield the
desired particle size in the chosen inhalation device.
[0092] Advantageously for administration as a dry powder a PEGylated insulin of this invention
is prepared in a particulate form with a particle size of less than about 10 µm, preferably
about 1 to about 5 µm. The preferred particle size is effective for delivery to the
alveoli of the patient's lung. Preferably, the dry powder is largely composed of particles
produced so that a majority of the particles have a size in the desired range. Advantageously,
at least about 50% of the dry powder is made of particles having a diameter less than
about 10 µm. Such formulations can be achieved by spray drying, milling, or critical
point condensation of a solution containing the PEGylated insulin of this invention
and other desired ingredients. Other methods also suitable for generating particles
useful in the current invention are known in the art.
[0093] The particles are usually separated from a dry powder formulation in a container
and then transported into the lung of a patient via a carrier air stream. Typically,
in current dry powder inhalers, the force for breaking up the solid is provided solely
by the patient's inhalation. In another type of inhaler, air flow generated by the
patient's inhalation activates an impeller motor which deagglomerates the particles.
[0094] Formulations of PEGylated insulins of this invention for administration from a dry
powder inhaler typically include a finely divided dry powder containing the derivative,
but the powder can also include a bulking agent, carrier, excipient, another additive,
or the like. Additives can be included in a dry powder formulation of PEGylated insulin,
e.g., to dilute the powder as required for delivery from the particular powder inhaler,
to facilitate processing of the formulation, to provide advantageous powder properties
to the formulation, to facilitate dispersion of the powder from the inhalation device,
to stabilize the formulation (for example, antioxidants or buffers), to provide taste
to the formulation, or the like. Advantageously, the additive does not adversely affect
the patient's airways. The PEGylated insulin can be mixed with an additive at a molecular
level or the solid formulation can include particles of the PEGylated insulin mixed
with or coated on particles of the additive. Typical additives include mono-, di-,
and polysaccharides; sugar alcohols and other polyols, such as, e.g., lactose, glucose,
raffinose, melezitose, lactitol, maltitol, trehalose, sucrose, mannitol, starch, or
combinations thereof; surfactants, such as sorbitols, diphosphatidyl choline, or lecithin;
or the like. Typically an additive, such as a bulking agent, is present in an amount
effective for a purpose described above, often at about 50% to about 90% by weight
of the formulation. Additional agents known in the art for formulation of a protein
such as insulin analogue protein can also be included in the formulation.
[0095] A spray including the PEGylated insulins of this invention can be produced by forcing
a suspension or solution of the PEGylated insulin through a nozzle under pressure.
The nozzle size and configuration, the applied pressure, and the liquid feed rate
can be chosen to achieve the desired output and particle size. An electrospray can
be produced, e.g., by an electric field in connection with a capillary or nozzle feed.
Advantageously, particles of insulin conjugate delivered by a sprayer have a particle
size less than about 10 µm, preferably in the range of about 1 µm to about 5 µm.
[0096] Formulations of PEGylated insulins of this invention suitable for use with a sprayer
will typically include the PEGylated insulins in an aqueous solution at a concentration
of from about 1 mg to about 500 mg of the PEGylated insulin per ml of solution. Depending
on the PEGylated insulin chosen and other factors known to the medical advisor, the
upper limit may be lower, e.g., 450, 400, 350, 300, 250, 200, 150, 120, 100 or 50
mg of the PEGylated insulin per ml of solution. The formulation can include agents
such as an excipient, a buffer, an isotonicity agent, a preservative, a surfactant,
and, preferably, zinc. The formulation can also include an excipient or agent for
stabilization of the PEGylated insulin, such as a buffer, a reducing agent, a bulk
protein, or a carbohydrate. Bulk proteins useful in formulating insulin conjugates
include albumin, protamine, or the like. Typical carbohydrates useful in formulating
the PEGylated insulin include sucrose, mannitol, lactose, trehalose, glucose, or the
like. The PEGylated insulins formulation can also include a surfactant, which can
reduce or prevent surface-induced aggregation of the insulin conjugate caused by atomization
of the solution in forming an aerosol. Various conventional surfactants can be employed,
such as polyoxyethylene fatty acid esters and alcohols, and polyoxyethylene sorbitol
fatty acid esters. Amounts will generally range between about 0.001 and about 4% by
weight of the formulation.
[0097] Pharmaceutical compositions containing a PEGylated insulin of this invention may
also be administered parenterally to patients in need of such a treatment. Parenteral
administration may be performed by subcutaneous, intramuscular or intravenous injection
by means of a syringe, optionally a pen-like syringe. Alternatively, parenteral administration
can be performed by means of an infusion pump.
[0098] Injectable compositions of the PEGylated insulins of this invention can be prepared
using the conventional techniques of the pharmaceutical industry which involve dissolving
and mixing the ingredients as appropriate to give the desired end product. Thus, according
to one procedure, a PEGylated insulin is dissolved in an amount of water which is
somewhat less than the final volume of the composition to be prepared. Zink, an isotonic
agent, a preservative and/or a buffer is/are added as required and the pH value of
the solution is adjusted - if necessary - using an acid, e.g., hydrochloric acid,
or a base, e.g., aqueous sodium hydroxide as needed. Finally, the volume of the solution
is adjusted with water to give the desired concentration of the ingredients.
[0099] In a further embodiment of this invention the buffer is selected from the group consisting
of sodium acetate, sodium carbonate, citrate, glycylglycine, histidine, glycine, lysine,
arginine, sodium dihydrogen phosphate, disodium hydrogen phosphate, sodium phosphate,
and tris(hydroxymethyl)-aminomethan, bicine, tricine, malic acid, succinate, maleic
acid, fumaric acid, tartaric acid, aspartic acid or mixtures thereof. Each one of
these specific buffers constitutes an alternative embodiment of this invention.
[0100] In a further embodiment of this invention the formulation further comprises a pharmaceutically
acceptable preservative which may be selected from the group consisting of phenol,
o-cresol, m-cresol, p-cresol, methyl p-hydroxybenzoate, propyl p-hydroxybenzoate,
2-phenoxyethanol, butyl p-hydroxybenzoate, 2-phenylethanol, benzyl alcohol, chlorobutanol,
and thiomerosal, bronopol, benzoic acid, imidurea, chlorohexidine, sodium dehydroacetate,
chlorocresol, ethyl p-hydroxybenzoate, benzethonium chloride, chlorphenesine (3-(4-chlorophenoxy)-1,2-propanediol)
or mixtures thereof. In a further embodiment of this invention the preservative is
present in a concentration from about 0.1 mg/ml to 20 mg/ml. In a further embodiment
of this invention the preservative is present in a concentration from about 0.1 mg/ml
to 5 mg/ml. In a further embodiment of this invention the preservative is present
in a concentration from about 5 mg/ml to 10 mg/ml. In a further embodiment of this
invention the preservative is present in a concentration from about 10 mg/ml to 20
mg/ml. Each one of these specific preservatives constitutes an alternative embodiment
of this invention. The use of a preservative in pharmaceutical compositions is well-known
to the skilled person. For convenience reference is made to
Remington: The Science and Practice of Pharmacy, 19th edition, 1995.
[0101] In a further embodiment of this invention, the formulation further comprises an isotonic
agent which may be selected from the group consisting of a salt (e.g., sodium chloride),
a sugar or sugar alcohol, an amino acid (for example, L-glycine, L-histidine, arginine,
lysine, isoleucine, aspartic acid, tryptophan or threonine), an alditol (e.g. glycerol
(glycerine), 1,2-propanediol (propyleneglycol), 1,3-propanediol or 1,3-butanediol),
polyethyleneglycol (e.g., PEG400) or mixtures thereof. Any sugar such as mono-, di-,
or polysaccharides, or water-soluble glucans, including for example fructose, glucose,
mannose, sorbose, xylose, maltose, lactose, sucrose, trehalose, dextran, pullulan,
dextrin, cyclodextrin, soluble starch, hydroxyethyl starch and carboxymethylcellulose-Na
may be used. In one embodiment the sugar additive is sucrose. Sugar alcohol is defined
as a C4-C8 hydrocarbon having at least one -OH group and includes, e.g., mannitol,
sorbitol, inositol, galactitol, dulcitol, xylitol, and arabitol. In one embodiment
the sugar alcohol additive is mannitol. The sugars or sugar alcohols mentioned above
may be used individually or in combination. There is no fixed limit to the amount
used, as long as the sugar or sugar alcohol is soluble in the liquid preparation and
does not adversely effect the stabilizing effects achieved using the methods of this
invention. In one embodiment, the sugar or sugar alcohol concentration is between
about 1 mg/ml and about 150 mg/ml. In a further embodiment of this invention the isotonic
agent is present in a concentration from about 1 mg/ml to 50 mg/ml. In a further embodiment
of this invention the isotonic agent is present in a concentration from about 1 mg/ml
to 7 mg/ml. In a further embodiment of this invention the isotonic agent is present
in a concentration from about 8 mg/ml to 24 mg/ml. In a further embodiment of this
invention the isotonic agent is present in a concentration from about 25 mg/ml to
50 mg/ml. Each one of these specific isotonic agents constitutes an alternative embodiment
of this invention. The use of an isotonic agent in pharmaceutical compositions is
well-known to the skilled person. For convenience reference is made to
Remington: The Science and Practice of Pharmacy, 19th edition, 1995.
[0102] Typical isotonic agents are sodium chloride, mannitol, dimethyl sulfone and glycerol
and typical preservatives are phenol, m-cresol, methyl p-hydroxybenzoate and benzyl
alcohol.
[0103] Examples of suitable buffers are sodium acetate, glycylglycine, HEPES (4-(2-hydroxyethyl)-1-piperazineethanesulfonic
acid) and sodium phosphate.
[0104] A composition for nasal administration of a PEGylated insulins of this invention
may, e.g., be prepared as described in European Patent No.
272,097.
[0105] Compositions containing PEGylated insulins of this invention can be used in the treatment
of states which are sensitive to insulin. Thus, they can be used in the treatment
of type 1 diabetes, type 2 diabetes and hyperglycaemia for example as sometimes seen
in seriously injured persons and persons who have undergone major surgery. The optimal
dose level for any patient will depend on a variety of factors including the efficacy
of the specific insulin derivative employed, the age, body weight, physical activity,
and diet of the patient, on a possible combination with other drugs, and on the severity
of the state to be treated. It is recommended that the daily dosage of the PEGylated
insulin of this invention be determined for each individual patient by those skilled
in the art in a similar way as for known insulin compositions.
PREFERRED FEATURES OF THIS INVENTION
[0106] The features of this invention are as follows:
- 1. A PEGylated insulin analogue wherein, in the parent insulin, the amino acid in
position A14 is Glu or His (i.e., E and H, according to the one letter code), the
amino acid in position B25 is His and which optionally further comprises one or more
additional mutations, and wherein the PEG moiety, via a linker, is attached to the
ε amino acid in the lysine residue in position B29.
- 2. A PEGylated insulin analogue according to clause 1 wherein the parent insulin comprises
the A14E mutation.
- 3. A PEGylated insulin analogue according to the preceding clause wherein, in the
parent insulin, apart from the mutation in position B25, there is only the mutation
in position A14 mentioned in the preceding clause.
- 4. A PEGylated insulin analogue according to clause 1 wherein the parent insulin comprises
the A14H mutation.
- 5. A PEGylated insulin analogue according to any of the preceding clauses wherein
the parent insulin analogue comprises the desB30 mutation.
- 6. A PEGylated insulin analogue according to any of the preceding clauses wherein
the one or more additional mutations within the parent insulin is selected from a
group consisting of: A(-1)P, A(0)P, A8H, A21G, B(-1)P, B(0)P, B1E, B1Q, B16E, B26D,
B27E, B28D, desB30, B31L, B32E.
- 7. A PEGylated insulin analogue according to the preceding clause, wherein the parent
insulin, apart from the mutations in positions A14 and B25, has only one of the mutations
mentioned in the previous clauses.
- 8. A PEGylated insulin analogue according to any one of the preceding clauses but
the last one (i.e. except clause 7), wherein the parent insulin, apart from the mutations
in positions A14 and B25, has exactly two of the mutations mentioned in the preceding
clause but one (i.e., mentioned in clause 5).
- 9. A PEGylated insulin analogue according to any one of the preceding clauses but
the last two (i.e. except clauses 7 and 8), wherein the parent insulin, apart from
the mutations in positions A14 and B25, has exactly three of the mutations mentioned
in the preceding clause but two (i.e., mentioned in clause 6).
- 10. A PEGylated insulin analogue according to any one of the preceding clauses but
the last two (i.e. except clauses 8 and 9) wherein, apart from the mutations in positions
A14 and B25, the only additional mutation is desB30.
- 11. A PEGylated insulin analogue, according to any one of the preceding clauses, comprising
the moiety -(OCH2CH2)n-, wherein n is in integer in the range from 2 to about 1000, preferably from 2 to
about 500, preferably from 2 to about 250, preferably from 2 to about 125, preferably
from 2 to about 50, preferably from 2 to about 25, and preferably from 2 to about
12.
- 12. A PEGylated insulin analogue, according to any one of the preceding, possible
clauses, wherein the polyethylene glycol moiety has a nominal molecular weight in
the range from about 200 to about 40,000, preferably from about 200 to about 30,000,
preferably from about 200 to about 20,000, preferably from about 200 to about 10,000,
preferably from about 200 to about 5,000, preferably from about 200 to about 2,000,
preferably from about 200 to about 1,000, and preferably from about 200 to about 750.
- 13. A PEGylated insulin analogue, according to any one of the preceding, possible
clauses, wherein the polyethylene glycol moiety is monodisperse.
- 14. A PEGylated insulin analogue, according to the preceding clause, wherein the polyethylene
glycol moiety has the general formula -(CH2CH2O)n-, wherein n is in an integer which is at least about 6, preferably at least about
10, and not more than about 110, preferably not more than about 75, and even more
preferred n is in the range from about 6 to about 30, preferably in the range from
about 10 to about 48.
- 15. A PEGylated insulin analogue, according to any one of the preceding possible clauses,
wherein the polyethylene glycol moiety is polydisperse.
- 16. A PEGylated insulin analogue, according to any one of the preceding, possible
clauses, wherein the polyethylene glycol moiety is linear, branched, forked or dumbbell
shaped.
- 17. A PEGylated insulin analogue, according to any one of the preceding, possible
clauses, comprising a group of the general formula -Q1-(OCH2CH2)n-R1, wherein Q1 is a linker connecting the polyethylene glycol moiety to an α- or γ-NH-group of an
amino acid in the extension, preferably via an amide or a carbamate bond, n is an
integer in the range from 2 to about 1000, and R1 is alkoxy or hydroxyl, preferably methoxy.
- 18. A PEGylated insulin analogue, according to the preceding clause, wherein n is
an integer in the range from 2 to about 500, preferably from 2 to about 500, preferably
from 2 to about 250, preferably from 2 to about 125, preferably from 2 to about 50,
and preferably from 2 to about 25.
- 19. A PEGylated insulin analogue, according to any one of the preceding, possible
clauses, wherein Q1 is -alkylene-CO-, which is connected to the -NH- residue of the insulin via the carbonyl
group.
- 20. A PEGylated insulin analogue, according to the preceding clause, wherein Q1 is ethylene carbonyl (-(CH2)2-CO-), which is connected to the -NH- residue via the carbonyl group.
- 21. A PEGylated insulin analogue, according to any one of the preceding, possible
clauses except the two last, wherein Q1 is -alkylene-NHCO-alkylene-CO-, which is connected to the -NH- residue of the insulin
via the carbonyl group.
- 22. A PEGylated insulin analogue, according to any one of the preceding, possible
clauses except the three last, wherein Q1 is -CO-alkylene-CO-.
- 23. A PEGylated insulin analogue, according to any one of the preceding, possible
clauses except the four last, wherein Q1 is -CO-(4-nitrophenoxy).
- 24. A PEGylated insulin analogue, according to any one of the preceding, possible
clauses except the five last, wherein Q1 is (-alkylene-NHCO-alkylene-O-alkylene-)pCHq-NHCO-alkylene-(OCH2CH2)r-NHCO-alkylene-CO-, wherein p is 1, 2 or 3, q is 0, 1 or 2, p + q is 3, and r is an
integer in the range from 1 to about 12, which is connected to the -NH- residue of
the insulin via the carbonyl group.
- 25. A PEGylated insulin analogue, according to any on of the preceding, possible clauses,
wherein Q1 is-CH2CO-, -CH2CH2CO-, -CH2CH2CH2CO-, -CH2CH(CH3)CO-, -CH2CH2CH2CH2CO-, - CH2CH2CH(CH3)CO-, -CH2CH2CH2CH2CH2CO-, -CH2CH2NH-COCH2CH2CO-, -CH2CH2NH-COCH2CH2CH2CO-, -CH2CH2CH2NH-COCH2CH2CO-, -CH2CH2CH2NH-COCH2CH2CH2CO-, - COCH2CH2CO-, -COCH2CH2CH2CO-, -CO-(4-nitrophenoxy), (-CH2CH2NHCOCH2CH2O-CH2)3CNHCOCH2CH2(OCH2CH2)4NHCOCH2CH2CO- or (-CH2CH2NHCOCH2CH2OCH2)3CNH-COCH2CH2(OCH2CH2)4NHCOCH2CH2CH2CO-.
- 26. A PEGylated insulin analogue, according to any one of the preceding, possible
clauses, wherein R1 is alkoxy.
- 27. A PEGylated insulin analogue, according to the preceding clause, wherein R1 is methoxy.
- 28. A compound according to any one of the preceding product clauses, which is any
one of the compounds mentioned specifically in the above specification such as in
the specific examples, especially any one of the examples 1 et seq. below
- 29. The use of a compound according to any one of the preceding product clauses for
the preparation of a pharmaceutical composition for the treatment of diabetes.
- 30. The use of a compound according to any one of the preceding product clauses for
the preparation of a pharmaceutical composition which can be administered pulmonary
for the treatment of diabetes.
- 31. The use of a compound according to any one of the preceding product clauses for
the preparation of a pharmaceutical composition which can be administered pulmonary
for the treatment of diabetes and which gives a long acting effect.
- 32. The use of a compound according to any one of the preceding product clauses for
the preparation of a powder pharmaceutical composition which can be administered pulmonary
for the treatment of diabetes.
- 33. The use of a compound according to any one of the preceding product clauses for
the preparation of a liquid pharmaceutical composition which can be administered pulmonary
for the treatment of diabetes.
- 34. The use of a compound according to any one of the preceding product clauses for
the preparation of a pharmaceutical composition which can be administered orally for
the treatment of diabetes.
- 35. A method of treatment of diabetes, the method comprising administering to a subject
in need thereof a therapeutically effective amount of a compound according to any
one of the preceding product clauses.
- 36. A composition containing human insulin as well as a PEGylated insulin analogue
according to any one of the preceding clauses.
- 37. A composition containing insulin aspart as well as a PEGylated insulin analogue
according to any one of the preceding clauses.
- 38. A composition containing insulin Lispro as well as a PEGylated insulin analogue
according to any one of the preceding clauses.
- 39. A composition containing insulin Glulisine as well as a PEGylated insulin analogue
according to any one of the preceding clauses.
- 40. A pharmaceutical composition comprising a biologically active amount of the insulin
analogue according to any one of the above clauses relating to insulin analogs and
a pharmaceutically acceptable carrier.
- 41. A method for the treatment, prevention or alleviation of hyperglycemia, type 2
diabetes, impaired glucose tolerance, type 1 diabetes, obesity, syndrome X or dyslipidemia
in a subject comprising administering to a subject an insulin analogue according to
any one of the above clauses relating to insulin analogs or a pharmaceutical composition
according to any one of the above clauses.
- 42. Use of a therapeutically effective amount of an insulin analogue according to
any one of the above clauses relating to insulin analogs for the preparation of a
pharmaceutical formulation for the treatment or prevention of hyperglycemia, type
2 diabetes, impaired glucose tolerance, type 1 diabetes, obesity, syndrome X or dyslipidemia.
- 43. A method of treatment of diabetes, the method comprising administering to a subject
in need thereof a therapeutically effective amount of a PEGylated insulin according
to any one of the preceding product clauses.
[0107] Combining one or more of the clauses described herein, optionally also with one or
more of the claims below, results in further clauses and the present invention relates
to all possible combinations of said clauses and claims.
[0108] All references, including publications, patent applications, and patents, cited herein
are hereby incorporated by reference in their entirety and to the same extent as if
each reference were individually and specifically indicated to be incorporated by
reference and were set forth in its entirety herein (to the maximum extent permitted
by law).
[0109] All headings and sub-headings are used herein for convenience only and should not
be construed as limiting the invention in any way.
[0110] The use of any and all examples, or exemplary language (e.g., "such as") provided
herein, is intended merely to better illuminate the invention and does not pose a
limitation on the scope of the invention unless otherwise claimed. No language in
the specification should be construed as indicating any non-claimed element as essential
to the practice of the invention.
[0111] The citation and incorporation of patent documents herein is done for convenience
only and does not reflect any view of the validity, patentability, and/or enforceability
of such patent documents. The mentioning herein of references is no admission that
they constitute prior art.
[0112] Herein, the word "comprise" is to be interpreted broadly meaning "include", "contain"
or "comprehend" (EPO guidelines C 4.13).
[0113] This invention includes all modifications and equivalents of the subject matter recited
in the claims appended hereto as permitted by applicable law.
[0114] In the following list, selected PEGylation reagents are listed as activated
N-hydroxysuccinimide esters (OSu). Obviously, other active esters may be employed,
such as 4-nitrophenoxy and many other active esters known to those skilled in the
art. The PEG (or mPEG) moiety, CH
3O-(CH
2CH
2O)
n-, can be of any size up to Mw 40.000 Da, e.g., 750 Da, 2000 Da, 5000 Da, 20.000 Da
and 40.000 Da. The mPEG moiety can be polydisperse but also monodisperse consisting
of mPEG's with well defined chain lengths (and, thus, molecular weights) of, e.g.,
12 or 24 repeating ethylene glycol units-denoted mdPEG
x for m: methyl/methoxy end-capped, d: discrete and x for the number of repeating ethylene
glucol residues, e.g., 12 or 24. The PEG moiety can be either straight chain or branched.
The structure/sequence of the PEG-residue on the extended insulin can formally be
obtained by replacing the leaving group (e.g., "-OSu") from the various PEGylation
reagents with "NH-insulin", where the insulin is PEGylated either in an epsilon position
in a lysine residue or in the alpha-amino position in the A- or B-chain (or both),
e. g.:
mPEG-COCH2CH2CO-OSu,
mPEG-COCH2CH2CH2CO-OSu,
mPEG-CH2CO-OSu,
mPEG-CH2CH2CO-OSu,
mPEG-CH2CH2CH2CO-OSu,
mPEG-CH2CH2CH2CH2CO-OSu,
mPEG-CH2CH2CH2CH2CH2CO-OSu,
mPEG-CH2CH(CH3)CO-OSu,
mPEG-CH2CH2CH(CH3)CO-OSu,
mPEG-CH2CH2NH-COCH2CH2CO-OSu,
mPEG-CH2CH2CH2NH-COCH2CH2CH2CO-OSu,
mPEG-CH2CH2CH2NH-COCH2CH2CO-OSu,
mPEG-CH2CH2NH-COCH2CH2CH2CO-OSu,
mPEG-CO-(4-nitrophenoxy),
(mdPEG12-CH2CH2NHCOCH2CH2OCH2)3CNHCOCH2CH2(OCH2CH2)4NHCOCH2CH2CO-OSu (or, in short: (mdPEG12)3-dPEG4-OSu),
(mdPEG12-CH2CH2NHCOCH2CH2OCH2)3CNHCOCH2CH2(OCH2CH2)4NHCOCH2CH2CH2CO-OSu (or, in short: (mdPEG12)3-dPEG4-OSu),
mdPEGx-COCH2CH2CO-OSu,
mdPEGx-COCH2CH2CH2CO-OSu,
mdPEGx-CH2CO-OSu,
mdPEGx-CH2CH2CO-OSu,
mdPEGx-CH2CH2CH2CO-OSu,
mdPEGx-CH2CH2CH2CH2CO-OSu,
mdPEGx-CH2CH2CH2CH2CH2CO-OSu,
mdPEGx-CH2CH(CH3)CO-OSu,
mdPEGx-CH2CH2CH(CH3)CO-OSu,
mdPEGx-CH2CH2NH-COCH2CH2CO-OSu,
mdPEGx-CH2CH2CH2NH-COCH2CH2CH2CO-OSu,
mdPEGx-CH2CH2CH2NH-COCH2CH2CO-OSu,
mdPEGx-CH2CH2NH-COCH2CH2CH2CO-OSu or mdPEGx-CO-(4-nitrophenoxy),
wherein x is an integer in the range from about 6 to about 48, e.g.,12 or 24.
[0115] In addition, larger PEGylation reagents can be prepared by assembling two or more
smaller PEG reagents. For example, end-capped PEG reagents as
N-hydroxysuccinimide esters like any of the ones above can be coupled to (optionally
protected) PEG moieties that are functionalised by amino-groups in one end and carboxylic
acid (esters) in the other end. After deprotection of the carboxylic acid (if necessary),
the carboxylic acid is activated eg. as the
N-hydroxysuccinimide ester to furnish a longer PEGylation reagent. If desired, the
obtained PEGylation reagent can be further extended by repeating the cycle one or
more times. This principle and methodology is illustrated below.
[0116] This methodology enables construction of larger monodisperse (and polydisperse) PEGylation
reagents of tailored sizes.
[0117] Examples of PEG residues of the invention includes:
mPEG750 (where "750" indicates the average molecular weight in Da),
mPEG2000,
mPEG5000,
mPEG10000,
mPEG20000,
mPEG30000,
mPEG40000,
mdPEG12, (wherein "12" in subscript indicates the number of PEG monomers - as defined herein
and e.g. by Quanta BioDesign Ltd.)
mdPEG24,
mdPEG3x12 (wherein "3x12" in subscript indicates that PEG is branched and composed of 3 arms
each composed of 12 PEG monomers - as defined herein (mdPEG12)3-dPEG4-OSu), and eg. by Quanta BioDesign Ltd.),
mdPEG4x4 (wherein "4x4" in subscript indicates that PEG is branched and composed of 4 arms
each composed of 4 PEG monomers- as defined herein (below in "preferred insulins")
and eg. by IRIS Biotech GMBH),
mdPEG12-dPEG12 (wherein mdPEG12-dPEG12 indicates that the PEG residue is assembled from a mdPEG12 residue and a amino-dPEG12-acid residue as indicated above and illustrated below),
mdPEG12-dPEG24,
mdPEG24-dPEG12,
mdPEG24-dPEG24,
mdPEG24-dPEG24-dPEG24,
mdPEG3x12-dPEG12,
mdPEG3x12-dPEG24-dPEG24,
mdPEG4x4-dPEG12 or
mdPEG4x4-dPEG24.
[0118] In the following, selected PEGylation reagents are listed as maleimide derivatives.
Obviously, as alternatives to the maleimide group, other Michael acceptors may be
employed, such as vinylsulfones and many other Michael acceptors known to those skilled
in the art. The PEG (or mPEG) moiety, CH
3O-(CH
2CH
2O)
n-, can be of any size up to Mw about 40.000 Da. The structure/sequence of the PEG-residue
on the extended insulin can formally be obtained by replacing the maleimide "MAL"
from the various PEGylation reagents with "3-thio-succinimidyl-Ala-insulin", where
the insulin is PEGylated at a free cysteine residue according to the scheme below:

[0119] This scheme illustrates PEGyltion on a terminal Cys. Obviously, Cys need not be placed
terminally to enable PEGylation.
[0120] An example of PEG-MAL is mPEG-MAL.
[0121] The PEGylated, extended insulins of this invention have in the following all been
named as if the linker connecting the PEG moiety to the insulin in all cases is a
(3-)propionyl linker. It is evident from the foregoing that many types of linkers
are commercially available and since it is not the exact structure/composition of
the linker that governs the beneficial effects of placing the PEG moiety at residues
outside the sequence of regular insulin, it is to be understood that all types of
linkers (cf. above) are within the scope of this invention.
[0122] Parent protease stabilised insulins of the invention comprise the following:
A14E, B25H human insulin;
A14E, B25H, desB30 human insulin;
A14H, B25H, human insulin and
A14H, B25H, desB30 human insulin.
[0123] Preferred protease stabilised PEGylated insulins of the invention that may be prepared
similarly as the protease stabilised PEGylated insulins described in the examples
includes:
A14E, B25H, B29K(NεmdPEG12-dPEG24-propionyl), desB30 Human insulin

The PEGylation reagent can be prepared as described in the following:
Preparation of omega-(methoxy-PEG11-propanoylamino)-PEG24-propanoic acid (mdPEG12-dPEG24_ acid)
[0124]

mdPEG
12 NHS ester (0.457 mmol, Quanta BioDesign Ltd. Product No 10262) and amino-dPEG
24 tert-butylester (0.416 mmol, Quanta BioDesign, Product No 10311) were dissolved seperately
in acetonitrile (each 10 mL) and then the two solutions were mixed, pH was adjusted
with DIPEA to pH 8 (measurement of pH was done using wet indicator strips). The resulting
mixture was stirred at RT overnight, and subsequently evaporated to dryness, followed
by treatment with TFA/DCM (1/1), 10 mL for 1 h at RT. The mixture was then evaporated
to dryness and stripped twice with DCM. The residue was purified by HPLC (2 cm, C18
column) using acetonitrile (AcCN)/0,1% TFA and water/0,1% TFA as eluents. Gradient:
10- 80% AcCN/TFA from 5-20 min. Fractions containing the desired compound were collected,
combined and evaporated to dryness resulting in
omega-(methoxy-PEG11-propanoylamino)PEG23-propanoic acid as an oil (249 mg, 35%).
LCMS: m/z: 1718 (M+1)
+.
Preparation of omega-(methoxy-PEG11-propanoylamino)-PEG24-propanoic acid N-hydroxysuccinimide ester (mdPEG12-dPEG24-NHS or mdPEG12-dPEG24-propanoic acid OSu ester)
[0125]

Omega-(methoxy-PEG
11-propanoylamino)PEG
24-propanoic acid (249 mg, 0.145 mmol) was dissolved in acetonitrile (10 mL) and pH
was adjusted to 8 by addition of DIPEA (measurement of pH was done using wet indicator
strips). TSTU (48 mg, 0.16 mmol) in acetonitrile (10 mL) was added and the mixture
was stirred at room temperature for 1.5 h, and evaporated to dryness. The residue
was dissolved in DCM and washed with hydrochloric acid (0.01 M), the organic phase
was dried (MgSO
4), filtered and the filtrate was evaporated to dryness. The resulting
omega-(methoxy-PEG11-propanoylamino)-PEG24 propanoic acid N-hydroxysuccinimide ester was used for coupling to insulin without further purification. LCMS: m/z 1813.8 (M+1)
+.
[0126] Similarly, other PEGylation reagents for the following preferred insulins may be
prepared similarly.
A14E, B25H, B29K(Nε(mdPEG24-yl-dPEG24-yl), desB30 Human insulin:

A14E, B25H, B29K(Nε(mdPEG12)3-dPEG4-yl), desB30 Human insulin:

A14E, B25H, B29K(Nε(mdPEG12)3-dPEG4-yl-dPEG12-yl), desB30 Human insulin:

A14E, B25H, B29K(Nε(mdPEG12)3-dPEG4-yl-dPEG24-yl), desB30 Human insulin:

A14E, B25H, B29K(Nε-3-mdPEG4x4-Propionyl), desB30 human insulin

A14E, B25H, B29K(Nε-3-mdPEG4x4-dPEG12-Propionyl), desB30 human insulin

A14E, B25H, B29K(Nε-3-mdPEG4x4-dPEG24-Propionyl), desB30 human insulin

EXAMPLES
[0127] The following examples are offered by way of illustration, not by limitation.
General Procedure (A) for preparation of PEGylated, protease stabilised insulins of
this invention
[0128] The general procedure (A) is illustrated in the first example.
Example 1, General procedure (A):
[0129]
A14E, B25H, B29K(Nε-3-mdPEG24-Propionyl), desB30 human insulin

A14E, B25H desB30 human insulin (1.5 g) was dissolved in 0.1 M Na2CO3 (34 ml) and pH was adjusted to 10 with 1N NaOH. mdPEG24-SPA (0.45 g, Quanta BioDesign Ltd.) dissolved in MeCN (16.8 ml) was added and the
mixture was slowly stirred for 1 hour. Water (25 ml) was added, pH was adjusted to
5.5 with 1N HCl and the mixture was lyophilised. The title compound was obtained by
preparative HPLC purification. Column: C18, 3 cm. A-Buffer: 0.1%TFA in MiliQ Water;
B-buffer: 0.1% TFA in acetonitrile. Gradient 10-55% B over 45 min. Yield: 650 mg.
MALDI-MS (matrix: HCCA); m/z: 6762, calcd: 6762.
[0130] This compound has substantial protracted pulmonary efficacy.
Example 2, General procedure (A):
[0131]
A14E, B25H, B29K(Nε-3-mPEG2.000-Propionyl), desB30 human insulin

MALDI-MS (matrix: sinapinic acid); m/z: 7850 (broad).
Example 3, General procedure (A):
[0132]
A14E, B25H, B29K(Nε-{mPEG750}Propionylcarbamoyl), desB30 human insulin

MALDI-MS (matrix: sinapinic acid); m/z: 6570 (broad).
Example 4, General procedure (A):
[0133]
A14E, B25H, B29K(Nε-3-{2-[2-(2-Methoxyethoxy)ethoxy]ethoxy}propionyl), desB30 human insulin

ES-MS; m/z: 5879.6. (deconvoluted)
Example 5, General procedure (A):
[0134]
B25H, B29K(Nε-3-(mdPEG12)Propionyl) human insulin

MALDI-MS (matrix: sinapinic acid); m/z: 6365.
Example 6:
Insulin receptor binding of the insulin derivatives of this invention
[0135] The affinity of the insulin derivatives of this invention for the human insulin receptor
is determined by a SPA assay (Scintillation Proximity Assay) microtiterplate antibody
capture assay. SPA-PVT antibody-binding beads, anti-mouse reagent (Amersham Biosciences,
Cat No. PRNQ0017) are mixed with 25 ml of binding buffer (100 mM HEPES pH 7.8; 100
mM sodium chloride, 10 mM MgSO
4, 0.025% Tween-20). Reagent mix for a single Packard Optiplate (Packard No. 6005190)
is composed of 2.4 µl of a 1:5000 diluted purified recombinant human insulin receptor
(either with or without exon 11), an amount of a stock solution of A14Tyr[
125I]-human insulin corresponding to 5000 cpm per 100 µl of reagent mix, 12 µl of a 1:1000
dilution of F12 antibody, 3 ml of SPA-beads and binding buffer to a total of 12 ml.
A total of 100 µl reagent mix is then added to each well in the Packard Optiplate
and a dilution series of the insulin derivative is made in the Optiplate from appropriate
samples. The samples are then incubated for 16 hours while gently shaken. The phases
are the then separated by centrifugation for 1 min and the plates counted in a Topcounter.
The binding data were fitted using the nonlinear regression algorithm in the GraphPad
Prism 2.01 (GraphPad Software, San Diego, CA).
Insulin receptor binding affinities of selected compounds of this invention:
[0136]
Ex. No: |
Insulin receptor binding, |
|
A-isoform (without exon 11): |
|
(Relative to human insulin) |
1 |
2.2% |
2 |
1.4% |
3 |
3.4% |
4 |
17% |
5 |
10% |
Example 7:
Comparison of proteolytic stability (Half-Life) of insulin analogues and human insulin
towards chymotrypsin
[0137] Proteolytic stability of human insulin and insulin analogues (0.6 mM, 10 µL) towards
chymotrypsin (0.34 or 3.4 µg, 3.4 µL of 0.1 or 1µg/µL) was measured after incubation
in 100mM NH
4HCO
3 pH8.1 or 5 mM NaP, 140 mM NaCl, 70 ppm Tween20, pH 7.4 and 37°C at a final volume
of 100 µL. At various times (0, 5, 15, 30, 60 min) samples were quenched with an equal
volume of 0.2%TFA and transferred to 5°C. Human insulin and insulin analogues were
immediately analyzed by RP-HPLC at 214 nm and the area under the peak corresponding
to intact protein was determined. Half-lives (T
1/2) were obtained from the curves and the fold increase/decrease compared to human insulin
was calculated (Stability relative fold).
Relative stability towards chymotrypsin digestion of selected compounds of this invention:
[0138]
Ex. No: |
Stability towards chymotrypsin digestion:
(Fold relative to human insulin) |
1 |
14x |
2 |
16x |
4 |
11x |
Example 8:
Blood glucose lowering effect after i.v. bolus injection in rat of the insulin derivatives
of this invention
[0139] Male Wistar rats, 200-300 g, fasted for 18 h, is anesthetized using either Hypnorm-Dormicum
s.c. (1.25 mg/ml Dormicum, 2.5 mg/ml fluanisone, 0.079 mg/ml fentanyl citrate) 2 ml/kg
as a priming dose (to timepoint -30 min prior to test substance dosing) and additional
1 ml /kg every 20 minutes.
[0140] The animals are dosed with an intravenous injection (tail vein), 1 ml/kg, of control
and test compounds (usual dose range 0.125-20 nmol/kg). Blood samples for the determination
of whole blood glucose concentration are collected in heparinized 10 µl glass tubes
by puncture of the capillary vessels in the tail tip to time-20min and 0 min (before
dosing), and to time 10, 20, 30, 40, 60, 80, 120, and 180 min after dosing. Blood
glucose concentrations are measured after dilution in analysis buffer by the immobilized
glucose oxidase method using an EBIO Plus autoanalyzer (Eppendorf, Germany). Mean
plasma glucose concentrations courses (mean ± SEM) are made for each dose and each
compound.
Example 9:
Potency of the insulin derivatives of this invention relative to human insulin
[0141] Sprague Dawley male rats weighing 238-383 g on the experimental day are used for
the clamp experiment. The rats have free access to feed under controlled ambient conditions
and are fasted overnight (from 3 pm) prior to the clamp experiment.
Experimental Protocol:
[0142] The rats are acclimatized in the animal facilities for at least 1 week prior to the
surgical procedure. Approximately 1 week prior to the clamp experiment, Tygon catheters
are inserted under halothane anaesthesia into the jugular vein (for infusion) and
the carotid artery (for blood sampling) and exteriorised and fixed on the back of
the neck. The rats are given Streptocilin vet. (Boehringer Ingelheim; 0.15 ml/rat,
i.m.) post-surgically and placed in an animal care unit (25 °C) during the recovery
period. In order to obtain analgesia, Anorphin (0.06 mg/rat, s.c.) is administered
during anaesthesia and Rimadyl (1.5 mg/kg, s.c.) is administered after full recovery
from the anaesthesia (2-3 h) and again once daily for 2 days.
[0143] At 7 am on the experimental day overnight fasted (from 3 pm the previous day) rats
are weighed and connected to the sampling syringes and infusion system (Harvard 22
Basic pumps, Harvard, and Perfectum Hypodermic glass syringe, Aldrich) and then placed
into individual clamp cages where they rest for ca. 45 min before start of experiment.
The rats are able to move freely on their usual bedding during the entire experiment
and have free access to drinking water. After a 30 min basal period during which plasma
glucose levels were measured at 10 min intervals, the insulin derivative to be tested
and human insulin (one dose level per rat, n = 6-7 per dose level) are infused (i.v.)
at a constant rate for 300 min. Plasma glucose levels are measured at 10 min intervals
throughout and infusion of 20% aqueous glucose is adjusted accordingly in order to
maintain euglyceamia. Samples of re-suspended erythrocytes are pooled from each rat
and returned in about ½ml volumes via the carotid catheter.
[0144] On each experimental day, samples of the solutions of the individual insulin derivatives
to be tested and the human insulin solution are taken before and at the end of the
clamp experiments and the concentrations of the peptides are confirmed by HPLC. Plasma
concentrations of rat insulin and C-peptide as well as of the insulin derivative to
be tested and human insulin are measured at relevant time points before and at the
end of the studies. Rats are killed at the end of experiment using a pentobarbital
overdose.
Example 10:
Pulmonary delivery of insulin derivatives to rats
[0145] The test substance will be dosed pulmonary by the drop instillation method. In brief,
male Wistar rats (app.250 g) are anaesthesized in app. 60 ml fentanyl/dehydrodenzperidol/-dormicum
given as a 6.6 ml/kg sc primingdose and followed by 3 maintainance doses of 3.3 ml/kg
sc with an interval of 30 min. Ten minutes after the induction of anaesthesia, basal
samples are obtained from the tail vein (t = -20 min) followed by a basal sample immediately
prior to the dosing of test substance (t=0). At t=0, the test substance is dosed intra
tracheally into one lung. A special cannula with rounded ending is mounted on a syringe
containing the 200 ul air and test substance (1 ml/kg). Via the orifice, the cannula
is introduced into the trachea and is forwarded into one of the main bronchi -just
passing the bifurcature. During the insertion, the neck is palpated from the exterior
to assure intratracheal positioning. The content of the syringe is injected followed
by 2 sec pause. Thereafter, the cannula is slowly drawn back. The rats are kept anaesthesized
during the test (blood samples for up to 4 or 8 hrs) and are euthanized after the
experiment.
BRIEF DESCRIPTION OF THE FIGURE(S)
[0146]
Fig. 1 is a rat intratracheal drop instillation of the insulin of example 1.